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Juned Siddique - One of the best experts on this subject based on the ideXlab platform.
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translating a heart disease Lifestyle Intervention into the community the south asian heart Lifestyle Intervention saheli study a randomized control trial
BMC Public Health, 2015Co-Authors: Namratha R Kandula, Swapna S Dave, Peter John D De Chavez, Himali Bharucha, Yasin Patel, Paola Seguil, Santosh Kumar, David W Baker, Bonnie Spring, Juned SiddiqueAbstract:Background South Asians (Asian Indians and Pakistanis) are the second fastest growing ethnic group in the United States (U.S.) and have an increased risk of atherosclerotic cardiovascular disease (ASCVD). This pilot study evaluated a culturally-salient, community-based healthy Lifestyle Intervention to reduce ASCVD risk among South Asians.
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translating a heart disease Lifestyle Intervention into the community the south asian heart Lifestyle Intervention saheli study a randomized control trial
BMC Public Health, 2015Co-Authors: Namratha R Kandula, Swapna S Dave, Peter John D De Chavez, Himali Bharucha, Yasin Patel, Paola Seguil, Santosh Kumar, David W Baker, Bonnie Spring, Juned SiddiqueAbstract:South Asians (Asian Indians and Pakistanis) are the second fastest growing ethnic group in the United States (U.S.) and have an increased risk of atherosclerotic cardiovascular disease (ASCVD). This pilot study evaluated a culturally-salient, community-based healthy Lifestyle Intervention to reduce ASCVD risk among South Asians. Through an academic-community partnership, medically underserved South Asian immigrants at risk for ASCVD were randomized into the South Asian Heart Lifestyle Intervention (SAHELI) study. The Intervention group attended 6 interactive group classes focused on increasing physical activity, healthful diet, weight, and stress management. They also received follow-up telephone support calls. The control group received translated print education materials about ASCVD and healthy behaviors. Primary outcomes were feasibility and initial efficacy, measured as change in moderate/vigorous physical activity and dietary saturated fat intake at 3- and 6-months. Secondary clinical and psychosocial outcomes were also measured. Participants’ (n = 63) average age was 50 (SD = 8) years, 63 % were female, 27 % had less than or equal to a high school education, one-third were limited English proficient, and mean BMI was 30 kg/m2 (SD ± 5). There were no significant differences in change in physical activity or saturated fat intake between the Intervention and control group. Compared to the control group, the Intervention group showed significant weight loss (−1.5 kg, p-value = 0.04) and had a greater sex-adjusted decrease in hemoglobin A1C (−0.43 %, p-value <0.01) at 6 months. Study retention was 100 %. This pilot study suggests that a culturally-salient, community-based Lifestyle Intervention was feasible for engaging medically underserved South Asian immigrants and more effective at addressing ASCVD risk factors than print health education materials. NCT01647438 , Date of Trial Registration: July 19, 2012
Namratha R Kandula - One of the best experts on this subject based on the ideXlab platform.
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translating a heart disease Lifestyle Intervention into the community the south asian heart Lifestyle Intervention saheli study a randomized control trial
BMC Public Health, 2015Co-Authors: Namratha R Kandula, Swapna S Dave, Peter John D De Chavez, Himali Bharucha, Yasin Patel, Paola Seguil, Santosh Kumar, David W Baker, Bonnie Spring, Juned SiddiqueAbstract:Background South Asians (Asian Indians and Pakistanis) are the second fastest growing ethnic group in the United States (U.S.) and have an increased risk of atherosclerotic cardiovascular disease (ASCVD). This pilot study evaluated a culturally-salient, community-based healthy Lifestyle Intervention to reduce ASCVD risk among South Asians.
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translating a heart disease Lifestyle Intervention into the community the south asian heart Lifestyle Intervention saheli study a randomized control trial
BMC Public Health, 2015Co-Authors: Namratha R Kandula, Swapna S Dave, Peter John D De Chavez, Himali Bharucha, Yasin Patel, Paola Seguil, Santosh Kumar, David W Baker, Bonnie Spring, Juned SiddiqueAbstract:South Asians (Asian Indians and Pakistanis) are the second fastest growing ethnic group in the United States (U.S.) and have an increased risk of atherosclerotic cardiovascular disease (ASCVD). This pilot study evaluated a culturally-salient, community-based healthy Lifestyle Intervention to reduce ASCVD risk among South Asians. Through an academic-community partnership, medically underserved South Asian immigrants at risk for ASCVD were randomized into the South Asian Heart Lifestyle Intervention (SAHELI) study. The Intervention group attended 6 interactive group classes focused on increasing physical activity, healthful diet, weight, and stress management. They also received follow-up telephone support calls. The control group received translated print education materials about ASCVD and healthy behaviors. Primary outcomes were feasibility and initial efficacy, measured as change in moderate/vigorous physical activity and dietary saturated fat intake at 3- and 6-months. Secondary clinical and psychosocial outcomes were also measured. Participants’ (n = 63) average age was 50 (SD = 8) years, 63 % were female, 27 % had less than or equal to a high school education, one-third were limited English proficient, and mean BMI was 30 kg/m2 (SD ± 5). There were no significant differences in change in physical activity or saturated fat intake between the Intervention and control group. Compared to the control group, the Intervention group showed significant weight loss (−1.5 kg, p-value = 0.04) and had a greater sex-adjusted decrease in hemoglobin A1C (−0.43 %, p-value <0.01) at 6 months. Study retention was 100 %. This pilot study suggests that a culturally-salient, community-based Lifestyle Intervention was feasible for engaging medically underserved South Asian immigrants and more effective at addressing ASCVD risk factors than print health education materials. NCT01647438 , Date of Trial Registration: July 19, 2012
John M Jakicic - One of the best experts on this subject based on the ideXlab platform.
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brain and white matter hyperintensity volumes after 10 years of random assignment to Lifestyle Intervention
Diabetes Care, 2016Co-Authors: Mark A Espeland, John M Jakicic, Rena R Wing, Kirk I Erickson, Rebecca H Neiberg, Thomas A Wadden, Lisa Desiderio, Guray Erus, Mengkang Hsieh, Christos DavatzikosAbstract:OBJECTIVE Type 2 diabetes increases the accumulation of brain white matter hyperintensities and loss of brain tissue. Behavioral Interventions to promote weight loss through dietary changes and increased physical activity may delay these adverse consequences. We assessed whether participation in a successful 10-year Lifestyle Intervention was associated with better profiles of brain structure. RESEARCH DESIGN AND METHODS At enrollment in the Action for Health in Diabetes clinical trial, participants had type 2 diabetes, were overweight or obese, and were aged 45–76 years. They were randomly assigned to receive 10 years of Lifestyle Intervention, which included group and individual counseling, or to a control group receiving diabetes support and education through group sessions on diet, physical activity, and social support. Following this Intervention, 319 participants from three sites underwent standardized structural brain magnetic resonance imaging and tests of cognitive function 10–12 years after randomization. RESULTS Total brain and hippocampus volumes were similar between Intervention groups. The mean (SE) white matter hyperintensity volume was 28% lower among Lifestyle Intervention participants compared with those receiving diabetes support and education: 1.59 (1.11) vs. 2.21 (1.11) cc ( P = 0.02). The mean ventricle volume was 9% lower: 28.93 (1.03) vs. 31.72 (1.03) cc ( P = 0.04). Assignment to Lifestyle Intervention was not associated with consistent differences in cognitive function compared with diabetes support and education. CONCLUSIONS Long-term weight loss Intervention may reduce the adverse impact of diabetes on brain structure. Determining whether this eventually delays cognitive decline and impairment requires further research.
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three year outcomes of bariatric surgery vs Lifestyle Intervention for type 2 diabetes mellitus treatment a randomized clinical trial
JAMA Surgery, 2015Co-Authors: Anita P Courcoulas, Rebecca H Neiberg, Steven H Belle, Sheila K Pierson, Jessie K Eagleton, Melissa A Kalarchian, James P Delany, Wei Lang, John M JakicicAbstract:Importance Questions remain about the role and durability of bariatric surgery for type 2 diabetes mellitus (T2DM). Objective To compare the remission of T2DM following surgical and nonsurgical treatments. Design, Setting, and Participants In this 3-arm randomized clinical trial conducted at the University of Pittsburgh Medical Center from October 1, 2009, to June 26, 2014, in Pittsburgh, Pennsylvania, outcomes were assessed 3 years after treating 61 obese participants aged 25 to 55 years with T2DM. Analysis was conducted with an intent-to-treat population. Interventions Participants were randomized to either an intensive Lifestyle weight loss Intervention for 1 year followed by a low-level Lifestyle Intervention for 2 years or surgical treatments (Roux-en-Y gastric bypass [RYGB] or laparoscopic adjustable gastric banding [LAGB]) followed by low-level Lifestyle Intervention in years 2 and 3. Main Outcomes and Measures Primary end points were partial and complete T2DM remission and secondary end points included diabetes medications and weight change. Results Body mass index (calculated as weight in kilograms divided by height in meters squared) was less than 35 for 26 participants (43%), 50 (82%) were women, and 13 (21%) were African American. Mean (SD) values were 100.5 (13.7) kg for weight, 47.3 (6.6) years for age, 7.8% (1.9%) for hemoglobin A 1c level, and 171.3 (72.5) mg/dL for fasting plasma glucose level. Partial or complete T2DM remission was achieved by 40% (n = 8) of RYGB, 29% (n = 6) of LAGB, and no intensive Lifestyle weight loss Intervention participants ( P = .004). The use of diabetes medications was reduced more in the surgical groups than the Lifestyle Intervention–alone group, with 65% of RYGB, 33% of LAGB, and none of the intensive Lifestyle weight loss Intervention participants going from using insulin or oral medication at baseline to no medication at year 3 ( P P Conclusions and Relevance Among obese participants with T2DM, bariatric surgery with 2 years of an adjunctive low-level Lifestyle Intervention resulted in more disease remission than did Lifestyle Intervention alone. Trial Registration clinicaltrials.gov Identifier:NCT01047735
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a long term intensive Lifestyle Intervention and physical function the look ahead movement and memory study
Obesity, 2015Co-Authors: Denise K Houston, John M Jakicic, George A Bray, Karen C Johnson, Rebecca H Neiberg, Xiaoyan Leng, Andrea L Hergenroeder, James O Hill, Anthony P Marsh, Jack W RejeskiAbstract:Objective To assess the long-term effects of an intensive Lifestyle Intervention on physical function using a randomized post-test design in the Look AHEAD trial. Methods Overweight and obese (BMI ≥ 25 kg m−2) middle-aged and older adults (aged 45-76 years at enrollment) with type 2 diabetes (n = 964) at four clinics in Look AHEAD, a trial evaluating an intensive Lifestyle Intervention (ILI) designed to achieve weight loss through caloric restriction and increased physical activity compared to diabetes support and education (DSE), underwent standardized assessments of performance-based physical function including an expanded short physical performance battery (SPPBexp), 20-m and 400-m walk, and grip and knee extensor strength 8 years post-randomization, during the trial's weight maintenance phase. Results Eight years post-randomization, individuals randomized to ILI had better SPPBexp scores [adjusted mean (SE) difference: 0.055 (0.022), P = 0.01] and faster 20-m and 400-m walk speeds [0.032 (0.012) m s−1, P = 0.01, and 0.025 (0.011) m s−1, P = 0.02, respectively] compared to those randomized to DSE. Achieved weight loss greatly attenuated the group differences in physical function, and the Intervention effect was no longer significant. Conclusions An intensive Lifestyle Intervention has long-term benefits for mobility function in overweight and obese middle-aged and older individuals with type 2 diabetes.
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effect of a Lifestyle Intervention on change in cardiorespiratory fitness in adults with type 2 diabetes results from the look ahead study
International Journal of Obesity, 2009Co-Authors: John M Jakicic, Sarah A Jaramillo, Ashok Balasubramanyam, Barbara Bancroft, Jeffery M Curtis, Anne E Mathews, Mark A Pereira, Judith G Regensteiner, Paul M RibislAbstract:Effect of a Lifestyle Intervention on change in cardiorespiratory fitness in adults with type 2 diabetes: results from the Look AHEAD Study
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the look ahead study a description of the Lifestyle Intervention and the evidence supporting it
Obesity, 2006Co-Authors: Thomas A Wadden, John M Jakicic, Linda M Delahanty, Jack W Rejeski, Delia Smith West, Don Williamson, Robert I Berkowitz, David E Kelley, Christine Tomchee, James O HillAbstract:The Look AHEAD (Action for Health in Diabetes) study is a multicenter, randomized controlled trial designed to determine whether intentional weight loss reduces cardiovascular morbidity and mortality in overweight individuals with type 2 diabetes. The study began in 2001 and is scheduled to conclude in 2012. A total of 5145 participants have been randomly assigned to a Lifestyle Intervention or to an enhanced usual care condition (i.e., diabetes support and education). This article describes the Lifestyle Intervention and the empirical evidence to support it. The two principal Intervention goals are to induce a mean loss >or = 7% of initial weight and to increase participants' moderately intense physical activity to > or =175 min/wk. For the first 6 months, participants attend one individual and three group sessions per month and are encouraged to replace two meals and one snack a day with liquid shakes and meal bars. From months 7 to 12, they attend one individual and two group meetings per month and continue to replace one meal per day (which is recommended for the study's duration). Starting at month 7, more intensive behavioral Interventions and weight loss medication are available from a toolbox, designed to help participants with limited weight loss. In Years 2 to 4, treatment is provided mainly on an individual basis and includes at least one on-site visit per month and a second contact by telephone, mail, or e-mail. After Year 4, participants are offered monthly individual visits. The Intervention is delivered by a multidisciplinary team that includes medical staff who monitor participants at risk of hypoglycemic episodes.
Linda M Delahanty - One of the best experts on this subject based on the ideXlab platform.
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design and participant characteristics of a primary care adaptation of the look ahead Lifestyle Intervention for weight loss in type 2 diabetes the real health diabetes study
Contemporary Clinical Trials, 2018Co-Authors: Linda M Delahanty, Yuchiao Chang, Douglas E Levy, Bianca Porneala, Amy Dushkin, Laurie Bissett, Valerie Goldman, Jeanna Perrotta, Anthony Romeo Rodriguez, Barbara ChaseAbstract:Abstract Background/Aims The REAL HEALTH -Diabetes Study is a practice-based clinical trial that adapted the Look AHEAD Lifestyle Intervention for implementation in primary care settings. The trial will compare the effectiveness and cost-effectiveness of in-person group Lifestyle Intervention, telephone group Lifestyle Intervention, and individual medical nutrition therapy (MNT), the current recommended standard of care in type 2 diabetes. The primary outcome is percent weight loss at 6 months with outcomes also measured at 12, 18, 24 (Intervention completion), and 36 months. Here, we describe the adaptation, trial design, implementation strategies, and baseline characteristics of enrolled participants. Methods The study is a three-arm, patient-level, randomized trial conducted in three community health centers (CHCs) and one diabetes practice affiliated with one academic medical center. Results The study used existing clinical infrastructure to recruit participants from study sites. Strategies for successful conduct of the trial included partnering with health-center based co-investigator clinicians, engaging primary care providers, and accommodating clinical workflows. Of 248 eligible patients who attended a screening visit, 211 enrolled, with 70 randomly assigned to in-person group Lifestyle Intervention, 72 to telephone group Lifestyle Intervention, and 69 to MNT. The cohort was 55% female, 29% non-white, with mean age 62 years and mean BMI 35 kg/m 2 . Enrollment rates were higher at CHC sites. Conclusions A practice-based randomized trial of a complex behavioral Lifestyle Intervention for type 2 diabetes can be implemented in community health and usual clinical settings. Participant and provider engagement was higher at local CHC sites reflecting the study implementation focus. Clinical Trial Registration: NCT02320253
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association of an intensive Lifestyle Intervention with remission of type 2 diabetes
JAMA, 2012Co-Authors: Edward W Gregg, Jeanne M Clark, Haiying Chen, Lynne E Wagenknecht, Linda M Delahanty, John P Bantle, Henry J Pownall, Karen C Johnson, Monika M Safford, Abbas E KitabchiAbstract:Context The frequency of remission of type 2 diabetes achievable with Lifestyle Intervention is unclear. Objective To examine the association of a long-term intensive weight-loss Intervention with the frequency of remission from type 2 diabetes to prediabetes or normoglycemia. Design, Setting, and Participants Ancillary observational analysis of a 4-year randomized controlled trial (baseline visit, August 2001–April 2004; last follow-up, April 2008) comparing an intensive Lifestyle Intervention (ILI) with a diabetes support and education control condition (DSE) among 4503 US adults with body mass index of 25 or higher and type 2 diabetes. Interventions Participants were randomly assigned to receive the ILI, which included weekly group and individual counseling in the first 6 months followed by 3 sessions per month for the second 6 months and twice-monthly contact and regular refresher group series and campaigns in years 2 to 4 (n=2241) or the DSE, which was an offer of 3 group sessions per year on diet, physical activity, and social support (n=2262). Main Outcome Measures Partial or complete remission of diabetes, defined as transition from meeting diabetes criteria to a prediabetes or nondiabetic level of glycemia (fasting plasma glucose 1c Results Intensive Lifestyle Intervention participants lost significantly more weight than DSE participants at year 1 (net difference, −7.9%; 95% CI, −8.3% to −7.6%) and at year 4 (−3.9%; 95% CI, −4.4% to −3.5%) and had greater fitness increases at year 1 (net difference, 15.4%; 95% CI, 13.7%-17.0%) and at year 4 (6.4%; 95% CI, 4.7%-8.1%) (P Conclusions In these exploratory analyses of overweight adults, an intensive Lifestyle Intervention was associated with a greater likelihood of partial remission of type 2 diabetes compared with diabetes support and education. However, the absolute remission rates were modest. Trial Registration clinicaltrials.gov Identifier: NCT00017953
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an expanded role for dietitians in maximising retention in nutrition and Lifestyle Intervention trials implications for clinical practice
Journal of Human Nutrition and Dietetics, 2010Co-Authors: Linda M DelahantyAbstract:The demand for clinical trials targeting Lifestyle Intervention has increased as a result of the escalation in obesity, diabetes mellitus and cardiovascular disease. Little is published about the strategies that dietitians have used to successfully screen potential study volunteers, implement Interventions and maximise adherence and retention in large multicentre National Institutes of Health funded nutrition and Lifestyle Intervention clinical trials. This paper discusses an expanded role for the contributions of dietitians as members of an interdisciplinary team based on research experiences in the Diabetes Control and Complications Trial, Diabetes Prevention Program and Look AHEAD (Action for Health in Diabetes). Many of the strategies and insights discussed are also relevant to effective clinical practice. Dietitians need to broaden their scope of practice so that they are integrated proactively into the screening and Intervention phases of large clinical trials to maximise retention and adherence to assigned nutrition, Lifestyle and behavioural Interventions. The skills of dietitians are a unique fit for this work and it is important that investigators and project managers consider including them in both the screening and Intervention phases of such clinical trials to maximise retention results.
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the look ahead study a description of the Lifestyle Intervention and the evidence supporting it
Obesity, 2006Co-Authors: Thomas A Wadden, John M Jakicic, Linda M Delahanty, Jack W Rejeski, Delia Smith West, Don Williamson, Robert I Berkowitz, David E Kelley, Christine Tomchee, James O HillAbstract:The Look AHEAD (Action for Health in Diabetes) study is a multicenter, randomized controlled trial designed to determine whether intentional weight loss reduces cardiovascular morbidity and mortality in overweight individuals with type 2 diabetes. The study began in 2001 and is scheduled to conclude in 2012. A total of 5145 participants have been randomly assigned to a Lifestyle Intervention or to an enhanced usual care condition (i.e., diabetes support and education). This article describes the Lifestyle Intervention and the empirical evidence to support it. The two principal Intervention goals are to induce a mean loss >or = 7% of initial weight and to increase participants' moderately intense physical activity to > or =175 min/wk. For the first 6 months, participants attend one individual and three group sessions per month and are encouraged to replace two meals and one snack a day with liquid shakes and meal bars. From months 7 to 12, they attend one individual and two group meetings per month and continue to replace one meal per day (which is recommended for the study's duration). Starting at month 7, more intensive behavioral Interventions and weight loss medication are available from a toolbox, designed to help participants with limited weight loss. In Years 2 to 4, treatment is provided mainly on an individual basis and includes at least one on-site visit per month and a second contact by telephone, mail, or e-mail. After Year 4, participants are offered monthly individual visits. The Intervention is delivered by a multidisciplinary team that includes medical staff who monitor participants at risk of hypoglycemic episodes.
Jack W Rejeski - One of the best experts on this subject based on the ideXlab platform.
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a long term intensive Lifestyle Intervention and physical function the look ahead movement and memory study
Obesity, 2015Co-Authors: Denise K Houston, John M Jakicic, George A Bray, Karen C Johnson, Rebecca H Neiberg, Xiaoyan Leng, Andrea L Hergenroeder, James O Hill, Anthony P Marsh, Jack W RejeskiAbstract:Objective To assess the long-term effects of an intensive Lifestyle Intervention on physical function using a randomized post-test design in the Look AHEAD trial. Methods Overweight and obese (BMI ≥ 25 kg m−2) middle-aged and older adults (aged 45-76 years at enrollment) with type 2 diabetes (n = 964) at four clinics in Look AHEAD, a trial evaluating an intensive Lifestyle Intervention (ILI) designed to achieve weight loss through caloric restriction and increased physical activity compared to diabetes support and education (DSE), underwent standardized assessments of performance-based physical function including an expanded short physical performance battery (SPPBexp), 20-m and 400-m walk, and grip and knee extensor strength 8 years post-randomization, during the trial's weight maintenance phase. Results Eight years post-randomization, individuals randomized to ILI had better SPPBexp scores [adjusted mean (SE) difference: 0.055 (0.022), P = 0.01] and faster 20-m and 400-m walk speeds [0.032 (0.012) m s−1, P = 0.01, and 0.025 (0.011) m s−1, P = 0.02, respectively] compared to those randomized to DSE. Achieved weight loss greatly attenuated the group differences in physical function, and the Intervention effect was no longer significant. Conclusions An intensive Lifestyle Intervention has long-term benefits for mobility function in overweight and obese middle-aged and older individuals with type 2 diabetes.
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the look ahead study a description of the Lifestyle Intervention and the evidence supporting it
Obesity, 2006Co-Authors: Thomas A Wadden, John M Jakicic, Linda M Delahanty, Jack W Rejeski, Delia Smith West, Don Williamson, Robert I Berkowitz, David E Kelley, Christine Tomchee, James O HillAbstract:The Look AHEAD (Action for Health in Diabetes) study is a multicenter, randomized controlled trial designed to determine whether intentional weight loss reduces cardiovascular morbidity and mortality in overweight individuals with type 2 diabetes. The study began in 2001 and is scheduled to conclude in 2012. A total of 5145 participants have been randomly assigned to a Lifestyle Intervention or to an enhanced usual care condition (i.e., diabetes support and education). This article describes the Lifestyle Intervention and the empirical evidence to support it. The two principal Intervention goals are to induce a mean loss >or = 7% of initial weight and to increase participants' moderately intense physical activity to > or =175 min/wk. For the first 6 months, participants attend one individual and three group sessions per month and are encouraged to replace two meals and one snack a day with liquid shakes and meal bars. From months 7 to 12, they attend one individual and two group meetings per month and continue to replace one meal per day (which is recommended for the study's duration). Starting at month 7, more intensive behavioral Interventions and weight loss medication are available from a toolbox, designed to help participants with limited weight loss. In Years 2 to 4, treatment is provided mainly on an individual basis and includes at least one on-site visit per month and a second contact by telephone, mail, or e-mail. After Year 4, participants are offered monthly individual visits. The Intervention is delivered by a multidisciplinary team that includes medical staff who monitor participants at risk of hypoglycemic episodes.